Online Application Form

    Select Title (required)


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    Membership Type (required)

    Payment Method (required)

    Declaration

    I certify that the above information is true and correct to the best of my knowledge.
    I understand that membership is voluntary and at my own risk.
    I agree to abide by the rules and constitution of the club.
    I agree to the information I have provided being stored on the club database, shared with other club members and for membership purposes.

    Privacy Notice

    Declaration

    By ticking this box, I confirm I have read and consent to the above Declaration and Privacy Notice

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    Once the Form is completed and sent, please complete payment via either;

    Bank Transfer. Details are below. (Please make sure you add your name as a reference so we know who the payment is to be credited for). 

    Electronic Payment Details

    Account Name: Kippax Harriers

    Sort Code: 40-39-21

    Account No: 01101536

    If you would like to pay by Cash or Cheque please arrange this with the Membership Secretary when you are contacted.

    Finally, If you would like to order a Kippax Harriers Running Vest (or any other Kippax Harriers Kit) please head on over to the Kit section here to order.